Discriminatory Formulary Language In HHS Proposal Brings Deluge Of Conflicting Comments
Executive Summary
HHS statements in a recent proposed rule identifying specific Affordable Care Act plan formulary practices as discriminatory elicit strong debate from insurance regulators, payers, patient advocates and pharma companies.
You may also be interested in...
Medicare-Negotiated Drugs May Not Get Favorable Coverage In Part D: Will CMS Intervene?
Insurance plans put on notice that CMS is concerned about restrictions on drugs with negotiated prices, but it’s not clear what the agency can or will do about it.
Medicare Spending Forecast For Leqembi Reflects CMS Angst About Alzheimer’s Drug Costs
The agency’s projection that Medicare will spend $3.5bn on Leqembi in 2025 is nearly three times the level of sales that marketer Eisai is expecting for the drug in North and South America combined in its fiscal year 2026.
Biosimilar Substitution In Medicare Part D Formularies Mid-Year Established In Final Rule
Policy may be helpful in promoting acceptance of follow-ons in Medicare but is not expected to result in near-term savings to the program.